| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,507.00 | $5,560.00 | $12,154.00 | |
Aetna
| Professional | $2,507.00 | $4,498.00 | $8,000.00 | |
Medica
| Facility | $2,578.00 | $5,634.00 | $27,042.18 | |
United
| Facility | $2,578.00 | $5,252.00 | $19,082.00 |